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European Journal of Nuclear Medicine and Molecular Imaging

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13.06.2023 | Original Article

^99mTc-Tilmanocept performance for sentinel node mapping in breast cancer, melanoma, and head and neck cancer: a systematic review and meta-analysis from a European expert panel

verfasst von: Guido Rovera, Elizabeth J. de Koster, Vittoria Rufini, Mariella Zollino, Luca Zagaria, Francesco Giammarile, Sergi Vidal-Sicart, Renato Valdés Olmos, Angela Collarino

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2023

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Abstract

Purpose

Although multiple radiopharmaceuticals are currently available for sentinel node (SN) biopsy, ^99mTc-tilmanocept is of particular interest due to its low molecular weight and specific binding capability for the mannose receptors of lymphatic reticuloendothelial cells. In the current systematic review and meta-analysis, we aimed to provide an update from a European expert panel on the performance of ^99mTc-tilmanocept for SN biopsy.

Methods

A systematic literature search of the PubMed/Medline and Embase databases was performed to identify studies on the use of ^99mTc-tilmanocept for SN identification in oncological patients. The articles’ methodological quality was assessed before inclusion. The pooled estimates of the pre-/intraoperative detection rates (DR; proportion of patients with ≥ 1 SN identified) and/or pN + sensitivity (SN + /pN + patients ratio), with 95% confidence intervals (CIs), were calculated for breast cancer, melanoma, and head and neck cancer.

Results

Twenty-four articles were included in the systematic review, and twenty-one provided data for the meta-analysis. According to data availability, the ^99mTc-tilmanocept-estimated pooled preoperative and intraoperative DRs were 0.94 (95%CI, 0.88–1.01) and 0.99 (0.98–1.00) for breast cancer, 0.98 (0.96–0.99) and 1.00 (0.99–1.00) for melanoma, and 0.97 (0.93–1.02) and 0.99 (0.96–1.01) for head and neck carcinoma. Finally, the pooled sensitivity for nodal metastasis in melanoma was 0.97 (95% CI, 0.92–1.03).

Conclusion

^99mTc-tilmanocept is a promising radiotracer for SN mapping in patients with breast cancer, melanoma, or head and neck cancer. We strongly believe that multicenter trials are still needed to assess if ^99mTc-tilmanocept is superior to other radiotracers used in clinical routine.

Nur mit Berechtigung zugänglich

Wilhelm AJ, Mijnhout GS, Franssen EJ. Radiopharmaceuticals in sentinel lymph-node detection - an overview. Eur J Nucl Med. 1999;26:S36-42.CrossRefPubMed

Giammarile F, Alazraki N, Aarsvold JN, Audisio RA, Glass E, Grant SF, et al. The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer. Eur J Nucl Med Mol Imaging. 2013;40:1932–47.CrossRefPubMed

Bluemel C, Herrmann K, Giammarile F, Nieweg OE, Dubreuil J, Testori A, et al. EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma. Eur J Nucl Med Mol Imaging. 2015;42:1750–66.CrossRefPubMed

Giammarile F, Schilling C, Gnanasegaran G, Bal C, Oyen WJG, Rubello D, et al. The EANM practical guidelines for sentinel lymph node localisation in oral cavity squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2019;46:623–37.CrossRefPubMed

Vera DR, Wallace AM, Hoh CK, Mattrey RF. A synthetic macromolecule for sentinel node detection: ^99mTc-DTPA-mannosyl-dextran. J Nucl Med. 2001;42:951–9.PubMed

Wallace AM, Hoh CK, Vera DR, Darrah DD, Schulteis G. Lymphoseek: a molecular radiopharmaceutical for sentinel node detection. Ann Surg Oncol. 2003;10:531–8.CrossRefPubMed

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.CrossRefPubMedPubMedCentral

Whiting PF, Rutjes AWS, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36.CrossRefPubMed

StataCorp. Stata Statistical Software: release 14. College Station, TX: StataCorp LP. College Station, TX: StataCorp LP: StataCorp LP; 2015.

10.

Wallace AM, Hoh CK, Ellner SJ, Darrah DD, Schulteis G, Vera DR. Lymphoseek: a molecular imaging agent for melanoma sentinel lymph node mapping. Ann Surg Oncol. 2007;14:913–21.CrossRefPubMed

11.

Wallace AM, Hoh CK, Darrah DD, Schulteis G, Vera DR. Sentinel lymph node mapping of breast cancer via intradermal administration of Lymphoseek. Nucl Med Biol. 2007;34:849–53.CrossRefPubMedPubMedCentral

12.

Wallace AM, Hoh CK, Limmer KK, Darrah DD, Schulteis G, Vera DR. Sentinel lymph node accumulation of Lymphoseek and Tc-99m-sulfur colloid using a “2-day” protocol. Nucl Med Biol. 2009;36:687–92.CrossRefPubMedPubMedCentral

13.

Leong SPL, Kim J, Ross M, Faries M, Scoggins CR, Metz WLR, et al. A phase 2 study of ^99mTc-tilmanocept in the detection of sentinel lymph nodes in melanoma and breast cancer. Ann Surg Oncol. 2011;18:961–9.CrossRefPubMedPubMedCentral

14.

Sondak VK, King DW, Zager JS, Schneebaum S, Kim J, Leong SPL, et al. Combined analysis of phase III trials evaluating [^99mTc]tilmanocept and vital blue dye for identification of sentinel lymph nodes in clinically node-negative cutaneous melanoma. Ann Surg Oncol. 2013;20:680–8.CrossRefPubMed

15.

Wallace AM, Han LK, Povoski SP, Deck K, Schneebaum S, Hall NC, et al. Comparative evaluation of [^99mTc]tilmanocept for sentinel lymph node mapping in breast cancer patients: results of two phase 3 trials. Ann Surg Oncol. 2013;20:2590–9.CrossRefPubMedPubMedCentral

16.

Marcinow AM, Hall N, Byrum E, Teknos TN, Old MO, Agrawal A. Use of a novel receptor-targeted (CD206) radiotracer, ^99mTc-tilmanocept, and SPECT/CT for sentinel lymph node detection in oral cavity squamous cell carcinoma: initial institutional report in an ongoing phase 3 study. JAMA Otolaryngol Head Neck Surg. 2013;139:895–902.CrossRefPubMedPubMedCentral

17.

Baker JL, Pu M, Tokin CA, Hoh CK, Vera DR, Messer K, et al. Comparison of [^99mTc]tilmanocept and filtered [^99mTc]sulfur colloid for identification of SLNs in breast cancer patients. Ann Surg Oncol. 2015;22:40–5.CrossRefPubMed

18.

Agrawal A, Civantos FJ, Brumund KT, Chepeha DB, Hall NC, Carroll WR, et al. [^99mTc]Tilmanocept accurately detects sentinel lymph nodes and predicts node pathology status in patients with oral squamous cell carcinoma of the head and neck: results of a phase III multi-institutional trial. Ann Surg Oncol. 2015;22:3708–15.CrossRefPubMedPubMedCentral

19.

Unkart JT, Baker JL, Hosseini A, Hoh CK, Wallace MS, Vera DR, et al. Comparison of post-injection site pain between technetium sulfur colloid and technetium tilmanocept in breast cancer patients undergoing sentinel lymph node biopsy. Ann Surg Oncol. 2015;22(Suppl 3):S559-565.CrossRefPubMed

20.

Unkart JT, Wallace AM. Use of ^99mTc-tilmanocept as a single agent for sentinel lymph node identification in breast cancer: a retrospective pilot study. J Nucl Med Technol. 2017;45:181–4.CrossRefPubMed

21.

Unkart JT, Hosseini A, Wallace AM. Tc-99m tilmanocept versus Tc-99m sulfur colloid in breast cancer sentinel lymph node identification: results from a randomized, blinded clinical trial. J Surg Oncol. 2017;116:819–23.CrossRefPubMed

22.

Unkart JT, Proudfoot J, Wallace AM. Outcomes of “one-day” vs “two-day” injection protocols using Tc-99m tilmanocept for sentinel lymph node biopsy in breast cancer. Breast J. 2018;24:526–30.CrossRefPubMed

23.

Silvestri C, Christopher A, Intenzo C, Kairys JC, Kim S, Willis A, et al. Consecutive case series of melanoma sentinel node biopsy for Lymphoseek compared to sulfur colloids. J Surg Res. 2019;233:149–53.CrossRefPubMed

24.

Murphy BL, Woodwick AR, Murphy KM, Chandler KJ, Johnson GB, Hunt CH, et al. ^99mTc-Tilmanocept versus ^99mTc-sulfur colloid in lymphoscintigraphy: sentinel lymph node identification and patient-reported pain. J Nucl Med Technol. 2019;47:300–4.CrossRefPubMed

25.

den Toom IJ, Mahieu R, van Rooij R, van Es RJJ, Hobbelink MGG, Krijger GC, et al. Sentinel lymph node detection in oral cancer: a within-patient comparison between [^99mTc]Tc-tilmanocept and [^99mTc]Tc-nanocolloid. Eur J Nucl Med Mol Imaging. 2020;

26.

Vidal-Sicart S, Rioja ME, Prieto A, Goñi E, Gómez I, Albala MD, et al. Sentinel lymph node biopsy in breast cancer with ^99mTc-tilmanocept: a multicenter study on real-life use of a novel tracer. J Nucl Med. 2021;62:620–7.CrossRefPubMed

27.

Doll C, Steffen C, Amthauer H, Thieme N, Elgeti T, Huang K, et al. Sentinel lymph node biopsy in early stages of oral squamous cell carcinoma using the receptor-targeted radiotracer 99mTc-tilmanocept. Diagnostics (Basel). 2021;11:1231.CrossRefPubMed

28.

Rietbergen DD, Pereira Arias-Bouda LM, van der Hage J, Valdés Olmos RA. Does ^99mTc-tilmanocept, as next generation radiotracer, meet with the requirements for improved sentinel node imaging? Rev Esp Med Nucl Imagen Mol. 2021;40:275–80.PubMed

29.

Mahieu R, den Toom IJ, van Rooij R, van Es RJJ, Hobbelink MGG, Krijger GC, et al. Diagnostic accuracy of [^99mTc]Tc-tilmanocept compared to [^99mTc]Tc-nanocolloid for sentinel lymph node identification in early-stage oral cancer. Clin Otolaryngol. 2021;46:1383–8.CrossRefPubMed

30.

Eckhoff A, Farrow NE, Silvestri C, Stroobant E, Intenzo C, Leddy M, et al. How much time is enough? Sentinel lymph node mapping time depends on the radiotracer agent. J Surg Oncol. 2022;125:712–8.CrossRefPubMed

31.

Mwagiru D, Shivashankar P, Wong E, Farlow D, Cambden B, Abdul-Razak M. Tilmanocept as a novel tracer for lymphatic mapping and sentinel lymph node biopsy in melanoma and oral cancer. ANZ J Surg. 2022;

32.

Ferez-Pinzon A, Corey SL, Rochani H, Rehl EA, Burak WE Jr. A prospective double-blinded randomized controlled trial comparing the intraoperative injection of technetium Tc 99m tilmanocept with technetium Tc 99m sulfur colloid in breast cancer lymphatic mapping. Breast J Hindawi. 2022;2022:9421489.

33.

Lymphoseek now FDA-approved for all solid tumors. Oncology Times. 2014;36:19.

34.

EMA. Lymphoseek [Internet]. European Medicines Agency. 2018 [cited 2023 Jan 20]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/lymphoseek.

35.

Vermeeren L, van der Ploeg IMC, Olmos RAV, Meinhardt W, Klop WMC, Kroon BBR, et al. SPECT/CT for preoperative sentinel node localization. J Surg Oncol. 2010;101:184–90.CrossRefPubMed

36.

Veenstra HJ, Vermeeren L, Olmos RAV, Nieweg OE. The additional value of lymphatic mapping with routine SPECT/CT in unselected patients with clinically localized melanoma. Ann Surg Oncol. 2012;19:1018–23.CrossRefPubMed

37.

Stojadinovic A, Peoples GE, Jurgens JS, Howard RS, Schuyler B, Kwon KH, et al. Standard versus pH-adjusted and lidocaine supplemented radiocolloid for patients undergoing sentinel-lymph-node mapping and biopsy for early breast cancer (PASSION-P trial): a double-blind, randomised controlled trial. Lancet Oncol. 2009;10:849–54.CrossRefPubMed

38.

van den Berg NS, Brouwer OR, Klop WMC, Karakullukcu B, Zuur CL, Tan IB, et al. Concomitant radio- and fluorescence-guided sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity using ICG-^99mTc-nanocolloid. Eur J Nucl Med Mol Imaging. 2012;39:1128–36.CrossRefPubMed

39.

van den Berg NS, Simon H, Kleinjan GH, Engelen T, Bunschoten A, Welling MM, et al. First-in-human evaluation of a hybrid modality that allows combined radio- and (near-infrared) fluorescence tracing during surgery. Eur J Nucl Med Mol Imaging. 2015;42:1639–47.CrossRefPubMed

40.

KleinJan GH, Van Werkhoven E, van Den Berg NS, Karakullukcu MB, Zijlmans HJ, Van Der Hage JA, et al. The best of both worlds: a hybrid approach for optimal pre- and intraoperative identification of sentinel lymph nodes. Eur J Nucl Med Mol Imaging. 2018;45:1915–25.CrossRefPubMedPubMedCentral

41.

Tokin CA, Cope FO, Metz WL, Blue MS, Potter BM, Abbruzzese BC, et al. The efficacy of tilmanocept in sentinel lymph mode mapping and identification in breast cancer patients: a comparative review and meta-analysis of the ⁹⁹mTc-labeled nanocolloid human serum albumin standard of care. Clin Exp Metastasis. 2012;29:681–6.CrossRefPubMed

Titel: 99mTc-Tilmanocept performance for sentinel node mapping in breast cancer, melanoma, and head and neck cancer: a systematic review and meta-analysis from a European expert panel
verfasst von: Guido Rovera
Elizabeth J. de Koster
Vittoria Rufini
Mariella Zollino
Luca Zagaria
Francesco Giammarile
Sergi Vidal-Sicart
Renato Valdés Olmos
Angela Collarino
Publikationsdatum: 13.06.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2023
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-023-06290-5

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^99mTc-Tilmanocept performance for sentinel node mapping in breast cancer, melanoma, and head and neck cancer: a systematic review and meta-analysis from a European expert panel

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

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Abstract

Purpose

Methods

Results

Conclusion

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